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KELLY L WILDES CDCA-PRE
NPI 1639996945
Counselor - Addiction (Substance Use Disorder) in Youngstown, OH

Active since September 26, 2024
527 N MERIDIAN RD, YOUNGSTOWN, OH 44509(330) 797-0070(330) 797-9146 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kelly L Wildes Cdca-pre NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY L WILDES CDCA-PRE (NPI 1639996945) is an individual addiction (substance use disorder) provider in Youngstown, Ohio, licensed in Ohio (CDCA.189536) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1639996945
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY L WILDESCredential: CDCA-PRE
Location Address527 N MERIDIAN RDYoungstown, OH 44509-1227
Mailing Address527 N Meridian RdYoungstown, OH 44509-1227 · (330) 797-0070 · Fax (330) 797-9146
Phone(330) 797-0070
Fax(330) 797-9146
Sole ProprietorNo
Enumeration DateSeptember 26, 2024
NPPES CertifiedSeptember 26, 2024
✔ NPI 1639996945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · CDCA.189536
527 N MERIDIAN RD, Youngstown, OH 44509
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVELYN C CLARK LPCC-S
Counselor (Professional)
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0070
TYLER BOULTON
Community/Behavioral Health
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0074
ALEXIS S MCANDREW LPCC
Counselor (Professional)
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0074
ANTOINETTE FITZGERALD LPN
Licensed Practical Nurse
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0070
KATALIN BACHA LPC
Counselor (Professional)
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0074
TARA L WARD RN
Registered Nurse
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0070
LAUREN G HOLT LSW
Social Worker
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0070
CHARIZMA M LEWIS LPN
Licensed Practical Nurse
527 N MERIDIAN RD
YOUNGSTOWN, OH 44509
Mahoning County (330) 797-0070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Wildes's NPI number?

The NPI number for Kelly Wildes is 1639996945. It was assigned to this individual provider in the NPPES registry on September 26, 2024.

Where is Kelly Wildes located?

Kelly Wildes practices at 527 N Meridian Rd, Youngstown, OH 44509. The listed phone number is (330) 797-0070.

What is Kelly Wildes's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Wildes was last updated on September 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.